Behavioral Medicine - 1

Medical conditions involving a change in emotion, thinking (cognition) and/or behavior. Associated with distress and/or difficulty functioning in social, work, and/or family life

Mental illness

Interdisciplinary field that integrates behavioral, psychosocial, and biomedical science knowledge and techniques

Behavioral medicine

Medical specialty for the diagnosis, treatment, and prevention of mental disorders

Psychiatry

What are the roles of the PA in psychiatry?

Primarily medical and primary psych (inpatient, outpatient, and both)

Who believed mental illness was a religious punishment or demonic possession?

Ancient Greece

Who recognized imbalances?

Hippocrates and Plato

What did Christianity used to think was the cause of mental illnesses?

Evil and demonic

When did we begin to recognize mental illness as a medical illness?

1800’s

When did we do institutionalization until the mid-century?

1900’s

What is a good tool to explain the etiologies/risk factors of mental illnesses?

Biopsychosocial model

What does DSM-5 stand for?

Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition

Assessment of psychiatric patients will differ by what?

Setting and by patient

Can medical conditions cause psychiatric symptoms?

Yes

What are the most important components that are done when finding out about psychiatric patients?

History, mental status exam, physical exam, and diagnostic tests

What is used to diagnose mental illnesses?

History

What are the parts of history?

Chief complaint and subjective history (including past medical history, social history, and family history)

What psychiatric patients need a physical exam?

All

What is the purpose of diagnostic testing for psychiatric patients?

Rule out other reasons

What are some standard laboratory tests for mental illnesses?

CBC, glucose, chemistries, TSH, U/A, tox screen, drug levels, HIV, CXR, EKG, EEG, and CT/MRI

What psychological evaluations should be done for psychiatric patients?

Intelligence tests and personality test

What is a major personality test that is used in psychiatry?

Rorschach evaluation

What is done during the introduction?

Observations and questions at the time of interview

Someone who is alert, impaired, has a messed-up posture, ragged clothes, their gender, or their race are descriptors of what?

Appearance

Someone who is cooperative, hostile, withdrawn, or pleasant are descriptors of what?

Attitude

The emotion reported by the patient is what?

Mood

Is mood subjective or objective?

Subjective

Observed expression is what?

Affect

Is affect subjective or objective?

Objective

What is a false sensory perception, not associated with real external stimuli?

Hallucination

What are the kinds of hallucinations people can have?

Auditory, visual, olfactory, tactile, and gustatory

What is a false belief that cannot be corrected by reasoning?

Delusion

What is a pathological persistence of a thought or feeling that cannot be eliminated by logical effort?

Obsession

What is a persistent, irrational, or exaggerated fear?

Phobia

What does S/I and H/I stand for

Suicidal ideation and homicidal ideation

What are the common with a hallucination?

Auditory and visual

What are the signs of a hallucination that points to it being an outside cause?

Olfactory, tactile, and gustatory

What do you ask when checking a patients orientation?

Who they are, where they are, and what time it is

What do you mark when someone passes their orientation test?

Alert and oriented x 3

What do you mark when they mess up on their orientation test?

Situation

What memories do you check for in a sensorium and cognition test?

Immediate, recent, and remote

What are some tests that can be done to check concentration?

Serial 7s and WORLD backwards

What are all the parts of a mental status exam (MSE)?

Introduction, general description, mood and affect, speech, perception, thought, and sensorium and cognition

What is another way to check sensorium and cognition without a full mental status exam?

Mini-mental exam

What are the parts of a biopsychosocial model?

Biological, psychological, and social